Advances in Graves' Disease, Including a New Mouse Model, Presented at American Thyroid Association Annual Meeting

October 28, 2014 — A unique mouse model of Graves’ disease, an autoimmune disorder that causes hyperthyroidism, and new research findings that may help improve the treatment of Graves’ disease will be highlighted in oral and poster presentations at the 84th Annual Meeting of the American Thyroid Association, October 29-November 2, 2014, in Coronado, California.

Sandra McLachlan, Ph.D. and colleagues from Cedars-Sinai Research Institute (Los Angeles, CA), have developed a new animal model of Graves’ disease, a research tool that could lead to a better understanding of the underlying cause of Graves’ disease and help in the development of a potential cure. In the presentation entitled “Development of a Unique Mouse Model for Graves’ Disease that Spontaneously Develops Pathogenic TSH Receptor Antibodies,” the authors report transgenic mice on a thyroiditis susceptible background that express a shed component of the human thyroid stimulating hormone receptor (TSHR) and spontaneously develop TSHR antibodies, as occurs in Graves’ disease.

Theo Plantinga, Ph.D., Radboud University Medical Center, (Nijmegen, The Netherlands) and colleagues, used next-generation sequencing technology to perform whole exome DNA sequence analysis and look for  a genetic cause of familial thyrostatic-induced agranulocytosis. Agranulocytosis is a rare side effect of thyrostatic treatment for Graves’ disease. The authors identified five individuals in two different families in whom agranulocytosis developed after treatment with propylthiouracil or thiamazole. Among the 15 genes found to have mutations in all five individuals, the most likely gene to cause agranulocytosis was the NOX3 gene. In their presentation, “Mutations in NOX3 as Genetic Cause of Familial Agranulocytosis during Thyrostatic Treatment of Graves’ Disease,” the authors note that they did not find mutations in NOX3 in the member of one family who had Graves’ disease and did not develop thyrostatic-induced agranulocytosis.

In the poster presentation “Can Thyroid Autoantibody Levels Aid In Treatment Decision-Making for Graves’ Disease?” Dawn Elfenbein, M.D., Ph.D., University of Wisconsin, Madison, describes a retrospective review of more than 450 patients who underwent either radioactive iodine (RAI) therapy (71% of patients) or thyroidectomy (29% of patients) during a six-year period. The percentage of patients who underwent surgery increased significantly over the study period, from 14% to 52%. The authors state that a patient’s decision whether to opt for treatment with RAI or surgery usually depends on the presence of clinical manifestations of Graves’ disease such as eye disease or goiter. Based on their review of measurements of thyroid-specific autoantibodies for patients with and without ophthalmopathy or goiter, they conclude that the autoantibody measurements are not predictive of these clinical features and, though useful for diagnosis, cannot help patients decide between surgery or RAI.

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The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 91st anniversary, the ATA delivers its mission — of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health — through several key endeavors: the publication of highly regarded professional journals, Thyroid, Clinical Thyroidology, and VideoEndocrinology; annual scientific meetings; biennial clinical and research symposia; research grant programs for young investigators, support of online professional, public and patient educational programs; and the development of guidelines for clinical management of thyroid disease and thyroid cancer. The ATA promotes thyroid awareness and information through its online Clinical Thyroidology for the Public (distributed free of charge to over 11,000 patients and public subscribers) and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet.